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. 2025 May 30;15:1554765. doi: 10.3389/fonc.2025.1554765

Table 4.

The narrative review of endocrine deficiency after proton beam therapy in children.

Author Patients PBT initiation age [yrs] Cancer type Medium dose [Gy] CRT Post-PBT observation time [yrs] Incidence of endocrine deficiency
Yip et. al. (2022)
(51)
32 Medulloblastoma - 38% 54.0 ± 4.4 Growth hormone deficiency – 37.5% vs 50.0% (CSI)
Hypothyroidism - 19%. vs 17.7% (CSI)
Sex Hormone Deficiency- 6.3% vs 0.0% (CSI)
Hormone Replacement Therapy 37.5% vs 50.0% (CSI)
Aldrich et al. (2021)
(52)
64 7.6 Medulloblastoma CSI<
30 Gy- 63.5 (n=40)
CSI≥30
(n=23)
nd 5.6 Primary Hypothyroidism- 28%
Growth hormone deficiency – 52.5%
Adrenal insufficiency- 5%
Endocrine replacement therapy- 55.0%
Sex Hormone Deficiency-2.5%
Precocious puberty- 17.5%
Bielamowicz et al. (2018)
(53)
41 Meduloblastoma nd 3.8 Hypothyroidism – 19.0%
Primary hypothyroidism - 7.3%
Central hypothyroidism – 9.8%
Eaton et al. (2016)
(54)
40 6.2 Medulloblastoma TB – 60 (n=24)
PF – 30 (n=12)
PF → TBa – 10 (n = 4)
+ 5.8 Hypothyroidism- 22.5%
Growth hormone deficiency- 52.5%
Adrenal insufficiency- 5%
Sex Hormone Deficiency-2.5%
Precocious puberty- 17.5%
Greenberger et al. (2014)
(55)
29 11.0 Low-grade gliomas of the brain or spinal cordOther-15.4% 52.2 ± 7.6 Growth hormone deficiency – 60.0%
Hypothyroidism – 47.5%
Cortisol insufficiency – 22.5%
Testosterone deficiency – 16.0%
Elevated prolactin – 12.5%
Diabetes Insipidus – 9.0%
Precocious Puberty – 6.0%
Viswanathan et al. (2011)
(56)
31 11.9 Craniopharyngioma - 7 
Medulloblastoma - 6 Glioma- 4 
Other – 14
F: 50.4
CSI: 54.0
± 1.8 Growth hormone deficiency (n = 6), TSH deficiency (n = 4), ACTH deficiency (n = 4), and hypogonadotropic hypogonadism (n = 4).
Yinuo Li et al. (2023)
(57)
11 8 Rhabdomyosarcoma - 2
Neuroblastoma- 8 Osteosarcoma- 1
± 2,04 The median relative change in irradiated kidney volume was 16.42% compared to the control group after 1 year.

CRT, conformal radiotherapy; CSI, craniospinal irradiation; nd, no data.